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RECOMMENDATIONS

Normal risk individuals: There is good evidence to support the inclusion of annual or biennial fecal occult blood testing (A recommendation) and fair evidence to include flexible sigmoidoscopy (B recommendation) in the periodic health examinations of asymptomatic individuals over age 50 years.
(A recommendation, B recommendation)

Normal risk individuals: there is insufficient evidence to make recommendation about whether only 1 or both of FOBT and sigmoidoscopy should be performed.
(C recommendation)

Normal risk individuals: There is insufficient evidence to include or exclude colonoscopy as an initial screen in the periodic health examination.
(C recommendation)

Above average risk individuals: There is fair evidence to support either genetic testing or flexible sigmoidoscopy of at risk individuals in FAP kindreds and screening with colonoscopy of patients in kindreds with the cancer family syndrome HNPCC.
(B recommendation)

Above average risk individuals: There is insufficient evidence to recommend colonoscopy for individuals who have a family history of colorectal polyps or cancer but do not fit the criteria for HNPCC.
(C recommendation)

NOTES

Development of better risk stratification for screening is a high research priority and further research, including randomized controlled trials, into the effectiveness and feasibility of other screening modalities is necessary.

Before each meeting, every member of the Canadian Task Force on Preventive Health Care (CTFPHC) and of the Evidence Review and Synthesis Centre (ERSC) completes a Declaration of Affiliations and Interests Form to report any potential conflicts of interest (e.g., financial, business or professional, intellectual). Disclosure is required for each new topic, and disclosures must be updated to reflect any changes that have occurred since an initial disclosure. Completed forms are kept on file, and outside experts who are asked to comment on the recommendations and documents prepared by the CTFPHC are also required to complete disclosure forms, which are kept on file. For more information, please refer to the CTFPHC’s Procedure Manual.